A Little Overwhelmed
It has always been my dream to breastfeed my children. This is my first baby (born on the 11th) and from the start it has been really troublesome. He absolutely would not latch for longer than 5 seconds for the first 20 hours or so. I had lactation consultants with me every couple of hours all day long and he just didn't get it. When he finally did, it was like a light bulb went off and he latched and fed for 15 minutes! It took my milk until this morning to come in, so there was an extra day in there because he didn't immediately begin nursing, so he screamed all day and all night because, although colostrum is enough nutrition-wise, it didn't satisfy him at all. My heart would break for him constantly when listening to his blood-curdling screams even though we were nursing constantly (30 mins on, 15 off roughly). His voice almost went away completely! I ended up going out and getting supplemental formula last night (I know, I hated it, too but I was so tired of watching him suffer). What I did was breastfeed for as long as I could and planned to give him a little of the formula if he still screamed, which he did. He took in about a half an ounce and slept until I had to feed him again 2 hours later (first time in two days).
This morning, I noticed that he seemed much more eager to latch on and feed (he had gotten to the point where he was beginning to become uninterested in nursing). Once he was done, I put him down and he fell asleep and slept for 2 hours just like he had done with the bit of formula. I knew immediately by his contentedness that my milk must have come in. I hand expressed some and, sure enough, it was SO different looking (white instead of clear) and came out a lot more than the colostrum ever did. I was the most relieved mama in the world!!! To say the least, today has been a good day all day. No fussy baby!
Then, this evening, while I was nursing (which is always very painful because of a few bad latches in the hospital which resulted in black spots directly on my nipples), my right nipple suddenly began stinging BADLY. I broke suction and looked down and my nipple was bleeding right near where one of those black spots was. My nipple was split open. Blood and a weird sticky goo came out. Now that nipple is very much more painful than it was before (obviously). I was told at the hospital by a pediatrician that Liam has a little bit of tongue tie. He said it is not bad enough to effect breastfeeding, so I was relieved by that because I DO NOT want him to have to have it clipped. I'm really stressing now about what his actual pediatrician will say tomorrow when I talk to her about his tongue tie. The latches no longer hurt so much. It more feels like my nipples are healing from the previous poor latches, but I don't know.
As you can see, this has been an ordeal for us, but I am determined to make BF work and to hold that bond with my baby boy. I absolutely love watching him BF, even when it's painful. The underlying love really takes the sting out. <3
Do any of you have a baby who had tongue tie and did not clip it and successfully BF? If he/she is older, how is his/her speech? What is that little black spot on my nipple? I left the hospital before I got the chance to ask a lactation specialist. It is painful and made that breast super painful to nurse on even before it cracked open this evening. And last, but not least, why did the nipple suddenly break open??
I plan to call the lactation specialists tomorrow, but I would love some support and advice!
Re: A Little Overwhelmed
Ah, the ol' "He's just a little bit tongue tied."
Both my boys were tongue tied. With DS1 I was told he was "a little bit tongue tied, it shouldn't affect nursing". Well, it didn't, but that's mostly because of my extreme oversupply and overactive letdown (I could spray several feet, it was crazy!). His "little" tongue tie resulted in him being extremely speech delayed -- at 2 years old he was completely silent. His pediatrician recommended speech therapy. I ended up taking him to an ENT and dentist who both said "Yep, he's tongue tied. It's probably what's preventing him from talking." His "little" tongue tie turned out to be one of the worst posterior tongue ties either had seen -- it was very thick, and very short. But because the tip of DS1's tongue was free, the pediatrician had said his tie didn't need clipping. The dentist ended up lasering the tie (heckuva lot cheaper and didn't require general anesthesia like the ENT would have). Releasing the tie and a short stint (6 months) in speech therapy brought DS1's speech up to his age group. Now, at 3.5, you'd never know that he'd been tongue tied. Can't get him to be quiet now! We are, however, still dealing with issues left over from the tongue tie -- reflux and tooth decay. Because his tongue wasn't mobile for over 2 years, he had really bad cavities, such that his four upper incisors are capped. He also had silent reflux that went undiagnosed until recently, but he's had the symptoms his whole life. His current pediatrician (a different one than the one that told me his tie was inconsequential) says it's likely a holdover from his tongue tie.
With DS2 I had it clipped when he was 3 weeks old. World of difference! The procedure was simple -- I swaddled him, they took him back, clipped it, and he was back nursing immediately afterward. I wish I had done it that early with DS1. DS2 is now 15 months old and is beginning to talk.
I highly recommend you have that tie checked by an ENT, and make sure it's not a posterior tie! And have him checked for an upper lip tie as well. Those can also affect speech, dental health, and nursing.
The black spots sound like scabs or small dots of blood, maybe? My guess is your nipple split open because of the tongue tie. If he's not sucking correctly, that will cause cracks and bleeding. Lanolin can help the cracks heal.
Re: A Little Overwhelmed
I agree with froggylogic. Don't be afraid to have the tt treated by someone who knows what they are doing if it is affecting breastfeeding. And if the tt is causing you pain, that is affecting breastfeeding even if baby is gaining ok.
But I think it is possible that you had scabbing from the early off latch, (poor latch would explain much of the other issues you have had as well) and one was pulled off. Yeouch, but the fact is the scabbing in the first place would possibly indicate that the nipple is healing, which would indicate the latch is improving. So, that is something to think about.
You do not mention output frequency (poops) or weight gain (and loss) so I assume that is all normal? Because the basic 'rules' are pretty simple. As long as baby is gaining normally (and that usually means losing weight at first) and nursing does not hurt mom, then all is basically well. The rest is fine tuning. If nursing hurts or baby is not gaining as baby should, (or lost way too much) that means something is not right, but these things are almost always fixable!
I think you followed your instincts with the supplementing, and I think tapping into your momma instincts is what it is all about.
ps, if you were not at least a 'little' overwhelmed at this stage, I would be worried. Personally I was a sobbing puddle the first two weeks with my oldest. Being overwhelmed is probably going to be your new normal for a bit. I promise you will get used to it.
Re: A Little Overwhelmed
Originally Posted by @llli*froggylogic
I think your doc struck out here, mama. If your nipples are blistered and cracked to the point where they split open, you're probably not talking about a "little" tongue tie. And as the PP said, getting a tongue tie fixed in infancy is not a big deal. I understand your reluctance to do it, but believe me, it does not get easier to fix these sorts of issues when kids are older. My older daughter has a lip tie that was not diagnosed until she was 7 and her permanent teeth started to come in with a huge gap between them. If her teeth keep on getting displaced by the tie, her dentist says she'll need to have it cut and then perhaps have braces. Great! Wish someone had pointed the tie out to me when she was tiny and it was causing all sorts of issues with nursing, or even when she was slightly older and not talking much, instead of figuring it out when she was 7 and totally mature enough to understand and freak out about the idea of someone cutting something in her mouth!!!
Regardless of what you do about the tie, I think you need to watch that cracked area REALLY carefully. If it gets bigger, I think that is a strong indication that the tongue tie really is causing problems. You want to watch the crack and the breast for signs of infection- a cracked nipple surface can be an entry point for the bacteria which can cause mastitis.
Some things to do for the cracks:
- Practice excellent breast hygiene- change nursing pads, bras, shirts, and towels daily and wash them in hot water and dry them in the sun (I hear NM has plenty of that!)
- Hydrate the cracks before nursing- use a shot glass full of warm water or a wet washcloth. Softened scabs tear open less painfully than hard, dry ones.
- My LC recommended using a combination of Bacitracin ointment and 1% hydrocortisone cream on cracks- the antibiotic fights infection, the hydrocortisone is for inflammation. Use a pea-sized amount, mixed and applied with a clean finger. Does not need to be washed off prior to nursing.
Re: A Little Overwhelmed
Yes! Seb had a tongue tie. It was clipped when he was 6 weeks old. I was VERY reluctant as well. We had the EXACT same scenario, when we first came home from the hospital I thought everything was going PERFECTLY! Then about 8 hours later my nipples started bleeding and cracking and were VERY VERY painful. I struggled to find support because we were released on a Saturday and the lactation department was not operating on the weekends. Frantic calls went out to my OB (who was on call-thank goodness) and a pediatric nurse line I had PAY for only to have the nurse tell me to "switch to formula because breastfeeding wasn't working for us" (I WAS PISSED.) Anyways, my OB was VERY helpful and got someone from the hospital nursery to call me. She suggested I pump and get into a lactation consultant ASAP. That advice worked better for me. So, I pumped and was happy to see my milk, it made me feel WAY better too. Seb took his first bottle at 3 days old and it broke my heart as I watched him gulp it down in 30 seconds. So, I remembered I had a friend who has been through the ringer with breastfeeding, I gave her a call and finally got some AMAZING advice-feed through the pain (get your partner's hand to squeeze, this really helps), rinse your nipples off after feedings and get some coconut oil. I did all of the above until I was able to get to the lactation consultant (though this took 4 days, because our hospital's lactation department is severely overbooked.) By the time I got into the LC everything seemed to be going a lot better and my nipples were not nearly as sore and had stopped bleeding-thanks coconut oil. The LC was AMAZING, she identified his tongue tie but silly me ignored her recommendation to get his tongue clipped because I thought we had turned the corner. Big mistake. At about 5 weeks in it happened again. Cracked, bloody painful nipples. With a tongue tie all it takes is ONE BAD LATCH and you are miserable. This bad latch occurred when I was feeding him in the backseat of my car. Funny how you remember these small details. Anyways, thats when my husband insisted we make an appointment with an ENT recommended by our pediatrician. BEST THING WE HAVE EVER DONE. Not only do my nipples not hurt but he his a much more efficient and less distracted breastfeeder now! The procedure is VERY VERY simple. You (or a nurse, but I preferred to do it myself) will hold him and the doctor will take tiny scissors and clip the frenulum then you will feed IMMEDIATELY (like, I already had my breast out and ready to go before he did the clip) after and he will stop crying and everything will be great! The doc said he could bleed for a few days or be fussy but we didn't experience either. The great thing about breast milk is that it heals the wound so quickly! Good luck! You are doing a fantastic job!